The team arrived home safely yesterday after uneventful travel. Not only were we greeted by our loving family, but also by this continuing tough Midwest winter, quite a change from the jungles of Gabon. It's great to be home, but I think I would prefer the hot, humid weather over what we have here.

Thanks to all for your prayers and support. It was another great trip filled with God's presence and love. He showed up at many times and places, some of them quite unexpectedly.

For “everyone who calls on the name of the Lord will be saved.” How then will they call on him in whom they have not believed? And how are they to believe in him of whom they have never heard? And how are they to hear without someone preaching? And how are they to preach unless they are sent? -Romans 10:13-15

So we finished up dinner with the lead surgeon and his family on our last evening in Bongolo and headed back to the guest apartment to pack. I was exhausted from 2 weeks of busy operating room days and teaching. The plan was to pack and get a much needed good nights sleep as we had an early departure the following morning. Well, God had a different plan. As I was getting my things together, I received a call from the surgeon about an emergency case. They wanted to bring an 8 year old who had a thyroidectomy earlier that day back to the operating room as she was bleeding in her neck and causing airway compromise. “Seriously God, this is the case you want me to do on my last night.” Getting this patient off to sleep would be a challenge in the US even with all the gadgets and resources available at my disposal. I could only imagine how this would go here in the jungle operating room.

Off I went down to the operating room. The child was stable but obviously had some airway obstruction and was having difficulty breathing. I gathered some resources and we brought the child to the operating room. Oh, and by the way, my anesthesia practice in the US is about 98% adults. “Really God, a difficult case and on a kid.” I prayed for this little one as we got started and felt a peace that the Great Physician would be with me along the way. “Just take the first step in faith and I will take care of you”, I could hear Him saying. While getting her to sleep and establishing an airway was a little tricky, it proceeded smoothly and uneventfully. They found the bleeding and fixed it. She woke up fine and was doing well when we left the next morning.

Life lesson learned again -- step out in faith and rely on God’s strength to make it through a tough situation.

God showed up in miraculous ways again at Bongolo Hospital. During a prior trip, one of the visiting physicians coined the phrase, “physiology is suspended at Bongolo Hospital.” In other words, the normal physiologic processes and outcomes that we see every day in the United States do not occur on some of the patients at Bongolo. Those that would normally have poor outcomes and even death are spared miraculously.

One such occurrence was a trauma that occurred on Wednesday. In the local town (Lebamba), two teenagers on a motorcycle were struck by a taxi and showed up in the ER. One had a broken femur and fractured bones around the right eye. The other had a broken femur and tibia and a presumed head injury. His level of consciousness was in and out, at times making sense, but most of the time was confused. He was initially scheduled to undergo emergent repair of his leg fractures, but in the interim took a turn for the worse, approaching a comatose state. We assumed he was bleeding inside his skull and rushed him to the operating room. We did not have any imaging of his head (unavailable) and presumed the bleeding in his skull was on the same side of a head laceration (it could have been on the other side just as well). After getting him off to sleep, the surgeon drilled a hole in his skull to evacuate the bleeding and release the pressure on the brain. I never thought I would be doing neurosurgery at Bongolo--simply incredible what was done in the jungle with limited resources.

The correct side was chosen as blood was coming out of the hole, but the source of bleeding could not be identified. Upon removing more of his skull, the presumed source of bleeding was identified and stopped. But, there was bleeding elsewhere, deeper in the brain. Not a good sign. We did not have the capability to go after this and closed him up. Given this finding, we felt he may not wake up from the surgery. While he was still asleep, the orthopedic surgeons temporarily fixed his leg fractures and it was time to wake him up. And that he did. While he was a bit sluggish, he was following commands appropriately, talking, and asking to eat shortly after surgery. For the next few days he continued to improve and did not show any further signs of bleeding inside his skull. The other bleeding we saw in surgery must have stopped. The other patient had his injuries fixed and is doing well also.

God intervened in many places during these traumas. In Africa, almost all of these types of trauma result in death as the patients either never make it to the hospital, and if they do, they do not go to the OR as the resources to fix these injuries are minimal. Even though these 2 patients made it to the OR, it still amazes me that the first one woke up and will likely survive.

These two teens, who would have likely not survived anywhere else in the country, now have a chance to lead normal lives. They now have a chance to hear about God and serve Him and glorify Him.

-On Saturday morning we did the first knee scope at Bongolo Hospital. It was a great success, not only technically, but most importantly, the patient did well and should have great results. Prior to the scope the thought was the patient would need a knee replacement and the scope would show likely this. But when they got in there, the patient had a large tear of the cartilage and no arthritis. It was cleaned up and he will likely not need a knee replacement for quite some time.

-We had a Super Bowl Party. While the game was horrible and the satellite feed did not show the commercials, it was a great time of fellowship, food, and fun. The party started at midnight with kickoff at 1230am. I retired soon after halftime.

-We had the opportunity to take the PAACS residents out for dinner one evening. When I say out for dinner, it is to the only restaurant in town. And when I say restaurant, I mean a simple one room building in front of a lady's home. She cooks the best food. The evening was one to remember with sharing and laughing with the people we are training. They are wonderful men of God, each with a fascinating story of how they arrived in the program. Over the last few years despite the barriers of geography, language and time, it has been special to build relationship with these men and challenge each other in our faith.

-Last evening we had dinner with one of the original missionaries to this hospital. She has been here 37 years. She is a nurse and helped start the hospital and nursing school. What a joy to hear some of her stories from the initial start up! Many of her stories ended with a praise to God for His guidance and protection. She also emphasized the power of prayer in her life. She will be retiring later this year and moving back to the US. Pray for her reentry into life in the US.

It has been a very busy week at the hospital. We have done a number of cases working late into the evening most days. The child with the diaphragmatic hernia did very well. Living to 18 months with this condition made him into a little fighter. Thank you for your prayers. While he still has a long way to go, at least he has a chance to grow up and live a life worshiping God.

As a part of the PAACS program (see link above for more info), the residents and faculty have a weekly discipleship session where we meet as a group and study the Bible. This past Thursday we met and one of the discussions centered on the "armor of God" from Ephesians chapter 6. One point was made that in the description Paul gives of the armor, there is nothing protecting the back. A question was posed as to why this may be the case. Some responses included always keeping an eye on your enemy and never turning your back. Another reply I found insightful. As Christian brothers and sister, we are called to look after each other and watch each other's backs. A common phrase today is "I got your back..." Here at Bongolo the staff is small and many of the physicians, nurses, and staff serve under this principle--watching each other's backs. This is certainly true if one spots a snake.

One person watching the backs of of the entire place is Paul. He is an American missionary in charge of the physical plant of the entire mission compound and hospital. He works tirelessly fixing this and that and responding to emergency issues that crop up. While not a physician or nurse, he is basically "on call" every night watching the backs of everyone here. Without his dedication and service to the behind the scenes stuff, it would be very difficult to run the place. God bless him and his wife, Melodee, in there service.